Comfort Care

When a year ago he arrived at the clinic, he was a hard-working man with neck pain, there with his expectant wife and their adoring toddler. No one had anticipated a tumor.

His hospital room was not the quiet ICU of my training. Every afternoon and weekend, his sister would drive his five kids and hers the thirty minutes up the highway to be with him, and every evening she took them back: always there was someone at the head of his bed. "Dale un besito a tu papá."

When I arrived to see them, his wife was beaming: he was awake. After weeks in a hospital delirium, his eyes had fluttered open, and though he couldn’t talk for the tube in his mouth, he was squeezing her fingers, batting his eyes. A woman arrived from their church, and together they prayed. Indeed, it felt like a miracle. Everyone knew this was not supposed to be his time.

The next visit, he was more alert still. The ICU team, led by a terse, efficient attending, came to announce that they were taking out the breathing tube but needed to know if the family would want it back. After brief negotiations, the respiratory therapist appeared. Out came the tube with just a small cough. “Do not talk,” she cautioned him, and so he didn’t, but he smiled quietly.

Finally though, on my last visit, when he could no longer bat his eyes and could only squeeze fingers in the moments between the dosing of his pain medication and the recurrence of his pain, there were questions about “comfort care.” To me, comfort care was the removal of treatments no longer helpful. To them, comfort care was abandoning him.

His own desires? To get up from that bed, get back to work, to hold his baby in his arms. He had been holding on by sheer will, it seemed, buoyed by the force of their dedication and love. On that day, I finally saw his mother wail, sitting beside him at the head of the bed. “How will I live without you?” His wife and I leaned against the wall facing the foot. “Mis hijos—” she would start, only to stop herself, her eyes welling up but refusing to allow the tears.

I choked back my own in what I imagined at the time was a show of respect, then let them flow out in my hot, parked car.